Digital Commons Network^™

Comparative Potency Testing Of Diphtheria Toxoid In Guinea Pigs And Mice For In-House Diphtheria-Tetanus-Pertussis And Diphtheria-Tetanus Vaccines, Wanlop Leeden, Supanee Ummalukacholk, Orawin Mangkhaladul, Eakachai Prompetchara

The Thai Journal of Pharmaceutical Sciences

Background: Diphtheria remains endemic in parts of Thailand and continues to threaten unvaccinated populations. To strengthen vaccine self-sufficiency, the Government Pharmaceutical Organization has developed in-house diphtheria–tetanus–pertussis (DTP) and diphtheria– tetanus (dT) vaccines. Potency testing of diphtheria toxoid is traditionally performed in guinea pigs; however, limitations in animal availability, cost, and logistics have prompted evaluation of alternative models.
Objectives: To compare diphtheria toxoid potency estimates of in-houseproduced DTP and dT vaccines using guinea pigs and mice, followed by a Vero cell-based toxin neutralization assay, and to assess the suitability of mice as an alternative model for potency testing.
Materials and Methods: …

Ai-Based Community Pharmacy Antibiotic Use Misuse Analysis: A Community-Based Study, Yasameen Riyadh Saeed Al-Azzawi

Muthanna Medical Journal

Background: The misuse of antibiotics in the community is a significant health issue of concern since it directly leads to antimicrobial resistance, treatment failure, and health care burden. Aim: determine the trend of antibiotic misuse in community pharmacies and to use analytical models based on artificial intelligence. Methods: The current research was carried out in a sample of the community pharmacies in the city of Hilla, Babylon, Iraq, between November 2025 and February 2026. There were 200 encounters of antibiotics dispensing. The structured recording form was used as the data collection instrument to record the sociodemographic data, presenting …

Skin Carotenoid Scores Reflect Immune Status Among Children Living With Hiv In Tanzania, Wilbert Mbuya, Thobias Boniphace, Michael Mwagala, Peter Agrea, Nazareth M Mbilinyi, Nancy E Moran, Andrew R Dinardo, Mkunde Chachage

Children’s Nutrition Research Center Staff Publications

Many individuals living with HIV experience persistent inflammation despite antiretroviral treatment, increasing their risk for cardiovascular diseases, cognitive decline, and other noncommunicable diseases. Carotenoids can inhibit this inflammation by reducing lipid peroxidation. Carotenoid intake and plasma concentrations can be approximated using a noninvasive cutaneous spectrophotometer. This study quantified skin carotenoid levels in Tanzanian children ages 5 to 15 years old (N = 185) both with and without HIV. Over 95% had low to moderate skin carotenoid scores (< 400 units). In children living with HIV, higher viral loads were linked to lower skin carotenoid scores (rho = -0.57, P < 0.001), whereas higher CD4 counts correlated with increased skin carotenoid scores (rho = 0.52, P < 0.001). Overall, carotenoid levels were low and associated with immune status, suggesting that elevated carotenoid scores correlate with lower inflammation in children living with HIV. Future studies investigating dietary carotenoid interventions to support immune function are warranted.

Gc-Ms Profiling And Antibacterial Activity Of Cold-Macerated Garlic Extracts Against Multidrug-Resistant Uropathogens, Fatima A. Khalaf, Saeed A. Fayadh

Karbala International Journal of Modern Science

The growing number of cases of multidrug-resistant (MDR) urinary tract infections has made the clinical management of urinary tract diseases a significant challenge; therefore, the need for effective adjunctive therapies cannot be overemphasized. This study evaluated the bioactive components and antibacterial efficacy of cold-macerated garlic extracts obtained using distilled water, 70% ethanol and hexane solvents against antimicrobial-resistant urinary isolates. Out of 250 urine samples that were analyzed, 124 (49.6%) showed significant microbial growth, with Escherichia coli being the most frequently isolated organism. The results of the phytochemical screening and Gas Chromatography-Mass Spectrometry (GC-MS) analysis showed that the ethanolic extract had …

Newborn Screening Reduces Survival Disparities In Scid After Stem Cell Transplant: A Pidtc Report, Lena E Winestone, Brent R Logan, Xuerong Liu, Olatundun Williams, Elizabeth A Dunn, Monica S Thakar, Sharon A Kidd, Talal Mousallem, Morna J Dorsey, Richard J O'Reilly, Neena Kapoor, Lisa Forbes Satter, Malika Kapadia, Soma C Jyonouchi, Sharat Chandra, Christen L Ebens, Deepakbabu Chellapandian, Sonali Chaudhury, Karin Chen, Blachy J Dávila Saldaña, Ahmad Rayes, Troy C Quigg, Shanmuganathan Chandrakasan, Jeffrey J Bednarski, Kenneth B Desantes, Pierre Teira, Alfred P Gillio, Hesham Eissa, Alan P Knutsen, Victor M Aquino, Evan B Shereck, Theodore B Moore, Emi H Caywood, Mark T Vander Lugt, Jacob Rozmus, Larisa Broglie, Lolie C Yu, Ami J Shah, Avni Y Joshi, Rebecca H Buckley, Jasmeen Dara, Joseph H Oved, Hisham Abdel Azim, Caridad A Martinez, Susan Prockop, Kathleen E Sullivan, Jack J Bleesing, Michael D Keller, Lisa M Madden, Suhag Parikh, Shalini Shenoy, Christine M Seroogy, Tamar Rubin, Jennifer Licata, Jeffrey R Andolina, Donald B Kohn, Lauri Burroughs, Jennifer W Leiding, Rebecca A Marsh, Luigi D Notarangelo, Sung-Yun Pai, Troy R Torgerson, Michael A Pulsipher, Jennifer Heimall, Geoffrey D E Cuvelier, Linda M Griffith, Jennifer M Puck, Christopher C Dvorak, Morton J Cowan, Elie Haddad

Faculty, Staff and Students Publications

Black race and Hispanic ethnicity are associated with higher mortality in severe combined immunodeficiency (SCID) following hematopoietic cell transplantation (HCT), though mechanisms remain unclear. We evaluated 796 children with SCID who received nonsibling HCT between 1982 and 2020 using data from the Primary Immune Deficiency Treatment Consortium. Overall survival for Black (aHR 2.47, 95%CI 1.64, 3.71) and Asian/Pacific Islander patients (aHR 1.82, 95%CI 1.00, 3.30) was significantly lower compared with non-Hispanic White patients, while Hispanic patients had lower event-free survival (aHR 1.83, 95%CI 1.27, 2.63) compared with non-Hispanic White patients. Even after adjusting for age and infection, Black patients with …

Enhancing Clinical Trial Literacy In Singapore: A Dnp Evaluation Of A Hbm-Guided Educational Video, Harini S. Shunmuga Velu, Barnaby Edward Young, Wentao Zhou

International Nursing Research Congress (INRC)

Background: Clinical trials are a cornerstone of modern healthcare [4]. However, approximately 80% of trials fail to enrol participants on time, costing millions and delaying essential treatment [1].This directly impedes progress toward Sustainable Development Goal Target 3.b. In Singapore, community participation remains modest due to micro-level barriers, including misconceptions, fear of exploitation, and limited research literacy. Advanced nursing leadership must promote this by promoting research literacy and informed ethical decision-making.

Purpose: The purpose is to systematically evaluate the effectiveness and implementation feasibility of a short, culturally-tailored educational video designed to enhance public knowledge, perceived safety, and willingness to participate in …

Radicular Back And Abdominal Pain With Ileus, Rash, And Siadh In Lyme Neuroborreliosis, Joyce Y. Quon, Roberta Delvy, Kelly Goo, Maureen Haque, Sarita Soares, Donna M. Windish

Journal of Community Hospital Internal Medicine Perspectives

Lyme disease is the most common tick-borne disease in the United States. Lyme neuroborreliosis occurs when systemic infection leads to neurologic involvement. Neuroborreliosis presents with a wide spectrum of clinical manifestations but classically presents with facial nerve palsy. Here, we present a case with a rare constellation of symptoms including radicular back and abdominal pain, ileus, rash, and SIADH due to Lyme disease with suspected neuroborreliosis. This case highlights the importance of recognizing atypical presentations of Lyme disease, especially for patients in Lyme endemic areas.

Mpox Coinfection With Coxsackie B Virus In A Transgender Host With Well-Controlled Hiv, Ranel Thaker, Ayesha Khan, Tommy Ojukwu Perdomo, Leilah Tisheh,

Journal of Community Hospital Internal Medicine Perspectives

Background: Mpox (formerly monkeypox) is a double-stranded DNA virus with increasing global prevalence, particularly among men who have sex with men (MSM) and individuals living with HIV. Co-infections with other viruses such as HSV and Varicella have been reported, but no documented cases with Coxsackievirus exist to date.

Case: We report the first known case of co-infection with Mpox and Coxsackie B virus in a 30-year-old transgender female with well-controlled HIV. The patient presented with a diffuse painful rash, perianal lesions, rectal pain, and constitutional symptoms. Physical examination revealed characteristic vesiculopustular lesions of Mpox, and laboratory testing confirmed …

When Steroid Injection Meets Rituximab: Disseminated Mssa, George Fawzy, Christlyn Blessing-Ujomor, Amna Anees

Journal of Community Hospital Internal Medicine Perspectives

Background: Septic arthritis is a rare but potentially fatal complication of intra-articular corticosteroid injection, commonly caused by Staphylococcus aureus. The risk is higher in older adults and those with diabetes, rheumatoid arthritis (RA), immunosuppression, or a history of recent joint procedures. Diagnostic delay is possible, as non-infectious arthritis can present with similar features. Although rituximab is generally considered safe, rituximab-associated hypogammaglobulinemia may increase susceptibility to severe infections. We report a case of methicillin-sensitive Staphylococcus aureus (MSSA) septic arthritis with hematogenous vertebral seeding following intra-articular corticosteroid injection in a patient receiving rituximab therapy.

Case: A 73-year-old man with seropositive RA, treated …

Cied-Related Infection Incidence And Clinical Outcomes In Adult Recipients Of Leadless Pacemakers, Abdullah Sahyouni, Esdras Panchame Pavon, Aylin Ma, Johny Alrahal, Matthew Guzie, Kirstenn Claire Calaguas, Steven H. Nguyen, Anjali Balla, Shruti Sreekanth, Bobby Malik, Robert Subbiondo, Yizhi Lin

Journal of Community Hospital Internal Medicine Perspectives

Infections of traditional pacemakers represent a serious complication as they are associated with significant morbidity and mortality. Unlike traditional pacemakers, which have a subcutaneous pocket and transvenous leads, leadless pacemakers have emerged as a promising alternative with a self-contained intracardiac design with significantly lower infection rates. The aim of this systematic review is to synthesize current research on device-related infections in leadless pacemaker recipients. A comprehensive review was performed through PubMed with the following key words, “leadless pacemaker,” “Micra,” “infection,” “PPM,” “conventional pacemaker,” yielding 291 articles. Then, articles were screened for relevance to infection rates among adult recipients of leadless …

The Hospitalist Support Team: The Foundation For Supporting A Seven-Specialty Hospitalist Group, Michael S. Wang, Austin Tiesenga, Tho Nguyen, William Schreiner, Gwendolyn Brainard, Samantha Labay

Journal of Community Hospital Internal Medicine Perspectives

Hospitalist medicine has grown considerably over the last 30 years. What began as internal medicine physicians filling the role of primary care physicians for their hospitalized patients has expanded to other specialties. This growth has created a need for both administrative and clinical support for these hospitalist specialties. To meet the needs of the adult Internal medicine-based group, a small community hospital created an administrative structure in order to facilitate clinical and administrative needs. As the administrative group began providing support to other specialties, this led to integration within the group. The program has grown to seven specialties and 56 …

Cryptococcal Meningitis: A Retrospective Analysis Of Immunocompetent And Immunocompromised Cases, Daniel Kotas, Ho-Man Yeung

Journal of Community Hospital Internal Medicine Perspectives

Introduction. Cryptococcal meningitis (CM) primarily affects immunocompromised individuals, but up to 20% of cases occur in immunocompetent patients. However, there are limited clinical comparisons between immunocompromised and immunocompetent patients.

Methods. This is an IRB approved, single-centered retrospective chart review study. Patients aged >18 admitted between 2012 and 2022 with Cryptococcus neoformans meningitis were included. Demographic, associated conditions, clinical data, and clinical outcomes were obtained. Patients were categorized into immunocompromised and immunocompetent groups.

Results. 37 patients with CM were identified, with 32 (86.5%) immunocompromised patients and 5 (13.5%) immunocompetent patients. The median time to first lumbar puncture was …

Clinical And Laboratory Predictors Of 30-Day Mortality In Hiv-Positive Adults With Pneumonia: A Prospective Observational Study From North India, Mandip Singh Bhatia, Ankita Kumari Bhargav, Saurabh Chandrabhan Sharda, Shankar Naidu, M. R Shivaprakash, Sunil Sethi, Vikas Gautam, Arnab Ghosh

Journal of Community Hospital Internal Medicine Perspectives

Background: Pneumonia remains a major cause of morbidity and mortality among people living with HIV (PLHIV), particularly in low- and middle-income countries. Despite the availability of antiretroviral therapy (ART), early mortality after hospitalization for pneumonia remains high. Indian data on short-term mortality predictors in HIV-associated pneumonia are limited.

Methods: We conducted a prospective observational study of HIV-positive adults admitted with pneumonia to a tertiary-care hospital in North India between April and December 2025. Clinical, laboratory, microbiological, and radiological parameters were recorded at admission. Patients were followed for 30 days. The primary outcome was all-cause 30-day mortality. Predictors of …

Multicentric Cross-Sectional Study On Determinants In Choosing Subspecialties In Internal Medicine And Job Satisfaction Among Internal Medicine Trainees And Specialists In The Usa, Indira Acharya, Onyekachi Ibe-Ejiogu, Mona Alkayyali, Ashik Pokharel, Nathan C Kilian, Mina M Al-Hamadani, Ashbina Pokharel, Jiling Chou, Christopher J Haas

Journal of Community Hospital Internal Medicine Perspectives

Background/ Purpose:

To analyze the sex distribution of physicians in a specific subspecialty, identify factors influencing subspecialty choice in internal medicine, assess job satisfaction, and evaluate burnout levels among Internal Medicine (IM) trainees and specialists.

Methods:

A questionnaire-based study was conducted using the Abridged Job Descriptive Index (AJDI) for job satisfaction and the Maslach Burnout Inventory (MBI) for burnout. Participants included IM residents, fellows, attendings, and hospitalists considering fellowship. Descriptive and statistical analyses, including Fisher's exact test, were performed using R to assess trends across subspecialties grouped by fellowship competitiveness.

Results:

A total of 162 IM physicians participated, with …

Universal Screening For Measles Immunity During Pregnancy: A Cost-Effectiveness Analysis, Anuradha Devabhaktuni, Sarah Boudova, Elias Kassir, Sohum Shah, Neil S. Silverman, Christina S. Han

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Measles is a highly contagious illness capable of causing significant morbidity and mortality, including adverse pregnancy outcomes. Routine screening for measles immunity is not currently recommended during pregnancy. Given the increasing frequency of measles outbreaks nationally and globally, awareness of measles immunity status can influence management of pregnant individuals who incur measles exposures and offer an opportunity for postpartum or preconception vaccination.

OBJECTIVE: We sought to evaluate the cost-effectiveness of universal screening for measles immunity during pregnancy in the United States.

STUDY DESIGN: A decision-analytic model was constructed to evaluate the cost-effectiveness of universal screening for measles immunity during …

Preparation Of Physician Assistant Students To Manage Patients Living With Hiv/Aids In A Primary Care Setting, Austin Parrish

SIU Journal of Medical Science Scholarly Works

This study examined Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP) educational exposure among clinical-phase physician assistant (PA) students and evaluated how well current curricula prepare future providers for HIV prevention and care. A cross-sectional survey of 109 PA students assessed HIV-related knowledge, clinical exposure, and awareness of key public health concepts, while lecture materials from 30 PA programs were analyzed for curricular content. Students demonstrated moderate but incomplete baseline knowledge, and fewer than one-quarter reported observing PrEP prescribing during primary care rotations. Awareness of Undetectable = Untransmittable (U=U) was limited, with only …

Adjunctive Probiotic Use During Antibiotic Exposure In Very Preterm Infants: A Narrative And Translational Review, Mustafa Törehan Aslan, Mustafa Altındiş, Fahri Ovalı

Journal of Pediatric Infectious Diseases

Infants born before 32 weeks of gestation are highly susceptible to late-onset sepsis because of immune immaturity, impaired intestinal barrier function, and frequent broad-spectrum antibiotic exposure. Whether probiotics should be continued or initiated during antibiotic therapy remains unresolved and is often conflated with routine prophylaxis in stable infants. This SANRA-guided structured narrative and translational review synthesized clinical, microbiome, resistome, mechanistic, and safety evidence identified in PubMed/MEDLINE, Scopus, and Web of Science through July 1, 2026, across three contexts: stable antibiotic overlap, suspected sepsis, and confirmed or unstable sepsis. Pooled prophylactic analyses suggest a small, heterogeneous reduction in late-onset infection (risk …

Paradoxical Reaction Presenting As Sacroiliitis In Brucellosis: A Case Report And Literature Review, Azer Karaman, Sümeyye Bayram, Hatice Gaber Kurt

Journal of Pediatric Infectious Diseases

Although brucellosis is one of the most common zoonotic infections worldwide, the development of a paradoxical reaction during treatment hasrarely been reported in the literature. We present a 17-year-old patient who developed acute sacroiliitis in the second week of treatment for olecranon bursitis brucellosis, despite her initial clinical findings showing signs of improvement. After excluding other potential etiologies for sacroiliitis, clinical and radiological recovery was achieved by adding anti-inflammatory therapy without modifying the existing antimicrobial regimen. Consequently, the clinical picture was evaluated as a paradoxical reaction. This case emphasizes that new symptoms or clinical worsening during brucellosis treatment should not …

Analysis Of Risk Factors And A Predictive Model For Recurrent Febrile Seizures Within A Single Febrile Illness In Children, Zheng Ge, Pao Yu, Kun Chen, Bi Zhou

Journal of Pediatric Infectious Diseases

Objective: To investigate predictive factors for seizure recurrence in children with febrile seizures (FS) within a single febrile illness, providing a basis for early clinical identification and preventive measures. Methods: We conducted a retrospective analysis of children with FS admitted to the Department of Pediatrics, Suzhou Hospital Affiliated to Anhui Medical University, from April 2023 to December 2025. A total of 337 children met the inclusion criteria. Children with more than one seizure within the same febrile ilness were classified as the recurrent febrile seizures (RFS) group, and those with a single seizure as the non-recurrent febrile seizures (NRFS) group. …

Beyond Pneumonia: Nonspecific And Extrapulmonary Manifestations Of Mycoplasma Pneumoniae Infection In Children, Svjetlana Mikulić

Journal of Pediatric Infectious Diseases

Mycoplasma pneumoniae is a well-recognized cause of respiratory infection in children, but its clinical spectrum extends beyond the lungs. Extrapulmonary manifestations may occasionally precede respiratory symptoms or dominate the presentation, making the diagnosis more difficult. This narrative clinical review focuses on nonspecific and extrapulmonary manifestations reported in pediatric patients, including neurological, mucocutaneous, hematological, cardiovascular, hepatic, gastrointestinal, and musculoskeletal complications. Relevant literature published between 2000 and 2026 was reviewed using PubMed/MEDLINE, Scopus, and Google Scholar. Most reported extrapulmonary manifestations appear to be immune-mediated, although direct microbial effects and vascular or prothrombotic mechanisms may contribute in selected cases. Clinical presentations range from …

Divergent Outcomes In Two Pediatric Cases Of Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis, Zhang Kai-Jing, Li Ran, You Deng-Xia, Li Yinjie, Qin Tian-Tian, Liang Xiao-Jing, Huang Jing

Journal of Pediatric Infectious Diseases

This study retrospectively analyzed the clinical data of two 19-month-old children diagnosed with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) who received treatment with a dexamethasone combined with etoposide (VP-16) regimen. Both children met the early remission criteria for body temperature, IL-10, and IFN-γ within 48-72 hours after treatment initiation, but their clinical outcomes were markedly different. In Case 1, the EBV-DNA load decreased significantly during the initial treatment phase, and platelet counts steadily increased after treatment; the patient had a favorable prognosis at the 2-year follow-up. In Case 2, the EBV-DNA load did not decrease but instead increased during the initial …

Age-Dependent Variations In Clinical Presentation, Laboratory Parameters, And Coronary Outcomes In Kawasaki Disease: A 10-Year Retrospective Cohort Study Of 480 Pediatric Patients In Eastern China, Zhuying Zhou, Chen Wang, Aole Li, Saeed Saboor, Xiaoli Li, Xiaowei Li, Xianmei Huang, Chunming Jiang

Journal of Pediatric Infectious Diseases

Objective: This study investigated the age-dependent clinical characteristics of Kawasaki disease (KD) in pediatric patients and assessed the influence of age on disease presentation and outcomes. Methods: A retrospective analysis was conducted of 480 children diagnosed with KD who were admitted to Hangzhou First People's Hospital between 2013 and 2022. Subjects were stratified into two cohorts based on age: <2 years and 2-14 years). Demographic data, clinical manifestations, laboratory parameters, comorbidities, and coronary artery abnormalities were comprehensively evaluated across the age groups. Results: Time from symptom onset to diagnosis was significantly prolonged in the older cohort (z=-2.70, P=0.007). The incidence of cervical lymphadenopathy was markedly higher in older children (χ²=15.12, P<0.001), while peripheral extremity changes were significantly less frequent (χ²=5.79, P=0.016). The younger cohort exhibited significantly elevated platelet counts, alanine aminotransferase, and NT-proBNP levels compared to older patients (z=-3.57, P<0.001; z=-2.39, P=0.02; z=-3.59, P<0.001, respectively). Coronary artery dilatation and aneurysm formation occurred more frequently in younger patients (z=7.70, P=0.006; z=14.63, P<0.001). However, coronary artery recovery rates following intravenous immunoglobulin therapy showed no significant inter-group differences (P>0.05). Conclusions: The clinical presentation of KD demonstrates significant age-dependent variation. Clinicians should maintain a high index of suspicion for KD in older children presenting with fever and cervical lymphadenopathy. In younger patients with KD, close monitoring of hepatic function, platelet …

A Case Of Hemophagocytic Lymphohistiocytosis Caused By Human Herpesvirus 6b, Lihong Gao, Yang Wen

Journal of Pediatric Infectious Diseases

Hemophagocytic lymphohistiocytosis (HLH) is a severe inflammatory response syndrome. Common infectious triggers include Epstein Barr virus, cytomegalovirus, bacteria, and other pathogens. We report a case of HLH caused by human herpesvirus-6 (HHV-6) in a pediatric patient. Based on the HLH-2004 diagnostic criteria, the patient fulfilled 5 of 8 criteria, establishing a definitive diagnosis. HHV-6-associated HLH is rarely reported in the literature. The etiological diagnosis was confirmed through metagenomic next - generation sequencing, highlighting its utility in identifying underlying causes of HLH when the etiology remains unknown.

Current Advances In Cancer Immunotherapy: Mechanisms, Therapeutic Strategies, Challenges, And Future Perspectives, Mohamed E. Abd El-Hack, Mahmoud Moustafa, Mahmoud Kamal, Vincenzo Tufarelli, Muhammad Arif, Laith Aldabbagh

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Cancer immunotherapy has emerged as a transformative therapeutic strategy that harnesses the host immune system to recognize and eliminate malignant cells. This review provides a comprehensive overview of current immunotherapeutic approaches, including immune checkpoint inhibitors (ICIs), monoclonal antibodies (mAbs), cancer vaccines, dendritic cell (DC)-based vaccines, chimeric antigen receptor (CAR)-T cell therapy, and oncolytic virus therapy. The mechanisms of action, therapeutic applications, and clinical benefits of each modality are discussed. Monoclonal antibodies selectively target tumor-associated antigens, whereas ICIs restore antitumor immunity by blocking inhibitory immune checkpoints. Cancer vaccines and DC-based vaccines enhance antigen-specific immune responses, while CAR-T cell therapy employs genetically …

Healthcare System Barriers To Somali Refugees In Kenya, Zahra Sharif Hashim

Walden Dissertations and Doctoral Studies

Access to health care is a fundamental right of every refugee, yet gaps in implementing Kenya's Refugees Acts of 2006 and 2021 continue to limit access for Somali refugees in Dadaab camp. Existing research has documented resource constraints, movement restrictions, and other barriers to refugee health care, but how policy implementation gaps shape access in Dadaab has not been well explored. The purpose of this qualitative descriptive study was to understand barriers to health care access for Somali refugees resulting from gaps in implementing Kenya's refugee health policies. The narrative policy framework guided the study. Data from semistructured interviews with …

Unmasking Myths And Facts About Actinomyces Species: Analysis From A Tertiary Care Hospital, Kanak Vats, Bhawna Sharma, Deepthi Nair

Muthanna Medical Journal

Actinomycetes are gram-positive, non-spore-forming, filamentous anaerobic bacteria that constitute part of the normal oral and intestinal flora and are widely distributed in the environment. Actinomycosis is a chronic, suppurative granulomatous infection frequently associated with deep-seated and recurrent infections. This five-year retrospective study (June 2018–June 2024) aimed to determine the prevalence and antimicrobial susceptibility pattern of Actinomyces species isolated from various clinical specimens. Samples received for Anaerobic culture and sensitivity were processed as per standard protocol and antibiogram was obtained for the respective pathogen isolated. Of the 508 specimens processed, 109 (21.4%) yielded pathogenic anaerobes, among which Actinomyces species accounted for …

Assessment Of Timp1, Transgelin-2, And Procalcitonin As Protein Biomarkers For Diagnosis And Prognosis Of Bloodstream Infection In A Critically Ill Cohort, Sajal Tiwary, Caroline A O'Neil, Sydney Lawless, Olivia Arter, Meghan Brown, Brittany Roemmich, Carleigh Samuels, Jennie H Kwon, Christopher W Farnsworth

2020-Current year OA Pubs

BACKGROUND: Bloodstream infections (BSI) are a significant contributor to morbidity and mortality among hospitalized patients. Rapid diagnosis of BSI is critical for timely and appropriate clinical management, but current diagnostic strategies have a prolonged turnaround time or only identify select pathogens with minimal prognostic information.

METHODS: We examined serial serologic samples from 77 intensive care unit (ICU) patients at time points before, during, and after diagnosis of presumptive BSI to identify host-derived protein biomarkers associated with specific organisms and with clinical outcomes in BSI. ICU patients with and without BSI were included. Two candidate biomarkers, tissue metalloproteinase 1 (TIMP-1) and …

Benchmarking Institutional Support For Point-Of-Care Testing Programs: Scale, Staffing, And Operational Challenges, Min Yu, Nam K Tran, Julie L V Shaw, Nicholas E Larkey, Nicole V Tolan, Andrew Szczembara, Leslie J Donato, Robert D Maynard, Adil I Khan

2020-Current year OA Pubs

BACKGROUND: Point-of-care testing (POCT) has expanded rapidly across healthcare systems, increasing both program scale and operational complexity. However, quantitative benchmarking data describing how POCT programs are structured and supported across institutions remain limited.

METHODS: We conducted a cross-sectional survey to characterize POCT program support, including program scope, staffing, operational practices, governance, and challenges. The survey was distributed electronically through professional networks, and 93 institutional responses were analyzed. Descriptive analyses were performed, and derived metrics, including sites per point-of-care testing coordinator (POCC), were used to evaluate the relationship between program scale and staffing.

RESULTS: POCT programs demonstrated substantial variability in scale, …

Current State And Needs Of Clinical Laboratories In Selected Countries In Africa, Merih Tesfazghi, Anne E Tebo, Roa Harb, Anthony O Okorodudu, Lee Schroeder, Jeannette Guarner, Christine Bales, Jack Ladenson, Allison Targowski, Kerry Cosby, Olajumoke Oladipo

2020-Current year OA Pubs

The Africa Working Group, under the auspices of the Global Laboratory Quality Initiative of the Association for Diagnostics & Laboratory Medicine (ADLM), conducted several educational workshops in Africa to promote laboratory quality in the region. The challenges faced in maintaining quality in clinical laboratories in low-resource countries may differ from region to region and country to country. To better understand current gaps and inform our engagement with partners in Africa, a needs assessment survey was distributed to 1427 ADLM members in Africa and further disseminated through local partners, resulting in 121 responses from participants across 8 countries in the region. …

Management And Outcomes Of Pediatric Necrotizing Pneumonia In The United States, Manette Ness-Cochinwala, Kaitlin Kobaitri, Paul Martinez, Balagangadhar R. Totapally

Journal of Pediatric Intensive Care

Introduction: Necrotizing pneumonia, an uncommon but serious condition in children, lacks comprehensive multicenter pediatric data. The objective was to assess treatment strategies and outcomes of necrotizing pneumonia in children. Methods: The Pediatric Health Information System was queried for patients, ages 30 days to 19 years, with lung necrosis. Children who received alteplase were compared with those who did not. The chi-square test, Mann-Whitney-U test, multivariable regression analysis, and propensity score matching were performed. Results: Out of a total of 2,177 children with necrotizing pneumonia, 59% had pleural effusion. A complex chronic condition (CCC) was present in 51% of patients. Resources …